Retroperitoneal ganglioneuroma: A report of diagnosis by fine-needle aspiration cytology

Ganglioneuroma is a rare benign tumor composed of nerve fibers and mature ganglion cells. Because it shares morphologic features with other neural tumors, both benign and malignant, accurate preoperative diagnosis is often difficult, but nonetheless, critical for proper management. The use of fine-needle aspiration (FNA) cytology in the diagnosis of ganglioneuroma has been rarely documented. In this report, a 25-yr-old man presented with a large retroperitoneal ganglioneuroma that was initially diagnosed by FNA cytology. This case illustrates the utility of FNA cytology in the diagnosis of ganglioneuroma and supports the routine incorporation of FNA cytology in the evaluation of retroperitoneal masses. Diagn. Cytopathol. 1998;19:385–387. © 1998 Wiley-Liss, Inc.     

Fine‐needle aspiration of neural lesions

The cytomorphologic features of 13 neural lesions sampled by fine‐needle aspiration (FNA) are reviewed. The frequencies at which various architectural features including Verocay bodies, filamentous background, and vascular arcades were present was recorded, along with the frequencies of cytologic findings including the presence of spindle cells, wavy nuclei, intranuclear inclusions, fishhook nuclei, nuclear pleomorphism, filamentous cytoplasm, and mitotic figures. Verocay bodies were a rare finding, present in only 1 of 11 cases. Vascular arcades were similarly infrequent (1/11 cases). Spindle‐shaped cells along with wavy nuclei were the most frequent findings, with fishhook‐shaped nuclei and a filamentous background of high frequency (9/11 cases). Our study indicates that some of the characteristic features recorded in the literature are rarely seen in needle aspiration smears, but features such as spindle‐shaped cells, wavy and fishhook‐shaped nuclei, and a filamentous background are relatively frequent findings. Diagn. Cytopathol. 1999;20:1–5. © 1999 Wiley‐Liss, Inc.     

颈静脉孔区神经鞘瘤的诊断及显微外科治疗

目的探讨颈静脉孔区神经鞘瘤的诊断及显微手术治疗方法。方法回顾分析我院2003年至2008年5例诊断为颈静脉孔区神经鞘瘤的患者临床资料。结果术后病理均证实为神经鞘瘤。全切肿瘤3例,次全切2例。术后3例有声音嘶哑伴吞咽困难,1例面部感觉麻木伴面瘫,随访中逐渐好转,1例听力丧失,余术后面神经和听神经功能均有所改善。结论根据临床症状和CT、MRI相结合可以进行正确诊断和肿瘤的分型。选择最佳手术入路,达到以最小的创伤而获得最佳的手术效果。     

腹膜后神经鞘瘤CT、MRI表现

目的 :研究腹膜后神经鞘瘤的CT、MRI表现及良恶性鉴别。方法 :本组经病理证实 13例 ,男 10例 ,女 3例 ,平均年龄45 .0岁。 13例中良性 4例 ,恶性 9例。 11例进行了CT平扫 ,其中CT强化 4例 ;MRI扫描 4例。结果 :肿瘤多见于脊柱旁腹膜后区及侧盆间隙。肿瘤 12 / 13例质地不均匀 ,9/ 13例有明显囊变区 ,未见淋巴结转移。良性者较小 ,边缘光滑 ;恶性者较大 ,呈不规则结节状 ,3/ 9例平扫CT可见钙化 ,4/ 4例CT强化不规则 ,7/ 9例显示侵犯特征 ,3/ 9例术后复发 ,4/ 9例出现转移。结论 :腹膜后间隙发生 ,有明显囊变征象肿瘤应考虑本病诊断 ,影像学表现可鉴别肿瘤良恶性质。     

Intraoperative mapping and monitoring of sensory vagal fibers during vagal schwannoma resection

Vagal schwannomas are rare, benign tumors. Intermittent intraoperative neuromonitoring via selective stimulation of splayed motor fibers running on the schwannoma surface to elicit a compound muscle action potential has been previously reported as a method of preserving vagal motor fibers. In this case report, vagal sensory fibers are mapped and continuously monitored intraoperatively during high vagus schwannoma resection using the laryngeal adductor reflex (LAR). Mapping of nerve fibers on the schwannoma surface enabled identification of sensory fibers. Continuous LAR monitoring during schwannoma subcapsular microsurgical dissection enabled sensory (and motor) vagal fibers to be monitored in real time with excellent postoperative functional outcomes. Laryngoscope, 129:E434–E436, 2019     

Partially intraosseous schwannoma of the distal humerus with increased enhancement after biopsy: Radiologic-pathologic correlation

Intraosseous schwannomas are rare benign tumors that most often occur at the mandible or sacrum. We present an unusual case of a bilobed schwannoma of the distal humerus with both intraosseous and extraosseous components. The extraosseous component was non-enhancing on initial MRI and enhanced on a subsequent MRI obtained after biopsy. We hypothesize that this change was attributable to decreased intra-tumoral pressure secondary to biopsy-related disruption of the tumor capsule.     

Surgical outcomes and factors related to postoperative motor and sensory deficits in resection for 244 cases of spinal schwannoma

In a large cohort the clinical presentation, management and outcomes of spinal schwannoma and factors related to postoperative motor and sensory deficits were invesgtigated. In 244 patients (males: 126, females: 118, average age 51.8 y) at one center, significant factors related to postoperative motor and sensory deficits were identified. Tumors were in the cervical (n = 79, 32.4%), lumbar (n = 66), thoracolumbar (T11-L1) (n = 55), and thoracic (n = 39) regions, and 5 patients had sacrum tumors. The rates of postoperative motor and sensory deterioration were 13.1% and 20.5%, respectively. The risk factors for motor deterioration were preoperative motor weakness, preoperative gait disturbance, dumbbell Eden type II, subtotal resection, and operative time, and those for postoperative sensory deficit were preoperative gait disturbance and subtotal resection. Of 12 patients with significant TcMEP changes, 11 had a new motor deficit after surgery; and of 216 patients with stable TcMEP data, 196 were neurologically intact after surgery (true negative) and 20 (11.0%) had deficits in the immediate postoperative stage (false negative). These deficits resolved during hospitalization for most patients. Of 15 patients with TcMEP deterioration and recovery, 11 (93.3%) had no motor deficits after surgery (p < 0.01).     

胃神经鞘瘤的CT表现

目的:探讨胃神经鞘瘤(GS)的CT特征,旨在提高对该肿瘤的CT诊断水平。方法:回顾性分析8例经手术病理证实的胃神经鞘瘤患者的临床影像资料,评估病灶部位、大小、形态、生长方式、密度及强化特点等。行腹部CT平扫及增强扫描者3例,仅行CT平扫者2例,仅行增强扫描者3例。结果:本组8例均为女性,年龄41~80岁不等,平均（56±12）岁,均为单发性胃神经鞘瘤,位于胃体、胃底者分别为3例、5例。肿瘤边界清晰,向腔内外双向生长者5例,腔内生长者2例,腔外生长者1例;病灶多呈类圆形或卵圆形,仅1例呈不规则浅分叶状;病灶大小不等,最大直径1.4~9.1 cm,平均值（4.94±2.32）cm;CT平扫病灶多表现为均匀等低密度,其中2例可见颗粒状钙化灶,增强扫描多呈渐进性均匀强化,仅1例呈渐进性不均匀强化。结论:胃神经鞘瘤CT平扫常表现为胃黏膜下的类圆形或卵圆形低密度肿块,增强扫描呈渐近性强化,这些特征有助于该病的术前准确诊断。     

Preservation of Facial Nerve Function Repaired by Using Fibrin Glue-Coated Collagen Fleece for a Totally Transected Facial Nerve during Vestibular Schwannoma Surgery

Recently, the increasing rates of facial nerve preservation after vestibular schwannoma (VS) surgery have been achieved. However, the management of a partially or completely damaged facial nerve remains an important issue. The authors report a patient who was had a good recovery after a facial nerve reconstruction using fibrin glue-coated collagen fleece for a totally transected facial nerve during VS surgery. And, we verifed the anatomical preservation and functional outcome of the facial nerve with postoperative diffusion tensor (DT) imaging facial nerve tractography, electroneurography (ENoG) and House-Brackmann (HB) grade. DT imaging tractography at the 3rd postoperative day revealed preservation of facial nerve. And facial nerve degeneration ratio was 94.1% at 7th postoperative day ENoG. At postoperative 3 months and 1 year follow-up examination with DT imaging facial nerve tractography and ENoG, good results for facial nerve function were observed.